ALTO Act

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 5197) to direct the Secretary of Health and Human Services to conduct a demonstration program to test alternative pain management protocols to limit the use of opioids in emergency departments, as amended.

Mr. Speaker, I ask unanimous consent that all Members may have 5 legislative days in which to revise and extend their remarks and insert extraneous material in the Record on the bill.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise today to express my strong support of H.R. 5197, the Alternatives to Opioids in the Emergency Department Act.

Emergency rooms are uniquely positioned to prevent addiction before it starts through the conservative and judicious prescribing of opioids. By establishing a demonstration program to test alternative pain management protocols to limit the use of opioids in hospital emergency departments, H.R. 5197 places emergency rooms on the front lines of defense against this opioid crisis.

Mr. Speaker, I thank Representative Pascrell and Representative McKinley, along with Representative DeGette and Representative Tipton for leading this important initiative.

Throughout my district in Oregon, I met with victims, families, treatment advocates, medical providers, and law enforcement officers on the front lines of this fight in our communities. That includes Mike Pelfrey of Grants Pass.

The first time I met Mike was at a roundtable in Medford, I think, in southern Oregon. Mike didn't really know anybody in the room. I had invited these folks to come around the table. They were addiction specialists, they were in the treatment programs, and they were law enforcement. I noticed he was there. He had heard the news about our meeting to discuss opioid abuse.

When we had finished going around the table, I said: So what brings you here, sir? And then he told me his family's story.

His son was injured in a school sporting accident and became addicted to the prescription painkillers provided by his medical provider to aid in his recovery.

Eventually, Mike's son made the all-too-familiar transition to a cheaper source. You would know it as heroin. And to this day, his son struggles with his addiction that began with opioid abuse.

Then he went on to talk about his sister, who also suffered from addiction. She was a nurse. His sister found herself with, frankly, a way to get easier access to pills than most. When coworkers and others caught on, she moved and continued her addiction and her ability to procure pills. He said that she died as a result of her addiction.

Mike came to the meeting in hopes that sharing the stories of his son and of his sister could help ensure such tragedies don't happen to other families.

At a more recent meeting I held in southern Oregon, Mike was present once more. During the meeting, Mike urged everyone to make combating the opioid crisis a top priority, saying, ``The only way we are going to do it is address it, do something about it, and make this an everyday part of our thought.''

Well, Mike, this Congress, we have made addressing this scourge an everyday part of our thoughts and efforts, and we will continue to do so no matter how long it takes to rip this terrible menace out of our communities.

We have an extraordinary opportunity to make important progress in this fight with the legislation before us, all of which reflects the feedback we have heard from people like you and from others at roundtables and meetings in our home districts.

Mr. Speaker, I want to say to Mike: You have been heard. We are acting. We are acting on your behalf and on the behalf of so many other Americans and American families who are dealing with this tragedy.

Mr. Speaker, I reserve the balance of my time.

Mr. Speaker, I yield myself such time as I may consume.

I want to commend the gentleman for bringing this to our attention with his colleagues. That was part of what we did back on Member Day. I think it was in October. We had 50 Members. I don't recall specifically whether Mr. Pascrell brought it to us there or some other time, but we are taking these real-life experiences from our districts, the things that work, and saying: This works. We know it works. It works in our hospital. It works in our town, and we are saying it can work nationwide.

We are taking ideas, like my friend from New Jersey has brought, Mr. Speaker, to our committee and now to this House floor. We are saying, let's apply this nationwide.

Together, we can overcome this epidemic. We must overcome this epidemic. It is in our ability to do this.

Mr. Speaker, I just say to the gentleman and my friend that we are not done, just as we weren't done 2 years ago when we modernized America's mental health laws. At that point, Mr. Murphy of Pennsylvania was here and gave us great counsel about how to do that. We put money in to deal with opioids then, that and 21st Century Cures that Mr. Upton and Ms. DeGette helped lead the effort on.

I know at NIH they are working day and night, as they are in other institutions, to find a nonaddictive pain management medicine. We wish them Godspeed in that effort, Mr. Speaker.

Mr. Speaker, I again thank my friend from New Jersey for bringing this to us. This is the kind of legislation that will save lives, prevent tragedy. We are going to get it passed here in a bipartisan, unanimous way, I do believe, in a matter of seconds.

Mr. Speaker, I urge my Members to support this bill, and I yield back the balance of my time.

Mr. Speaker, I rise today in support of H.R. 5197, the Alternatives to Opioids, ALTO, in the Emergency Department Act.

I would like to thank Chairman Walden and Ranking Member Pallone for their work, not only today, but leading up to today. This is moving quickly on us. They have reviewed the legislation very carefully and have offered very, very good advice on all of these pieces of legislation. The leadership here is outstanding.

Mr. Speaker, I want to give a special thank you to my colleague, David McKinley, who sponsored this legislation with me and has been an essential partner.

I am glad to see this body come together in a bipartisan manner to address a problem that is ravaging every corner of our districts.

I believe the bills being considered today should be seen as only a small part of an ongoing discussion and, more importantly, resources needed to reverse the unyielding trend of this epidemic.

Opioids are contributing to 115 people dying a day. If you go back to the HIV epidemic at the end of the 1980s and early 1990s, you will see similar numbers. Until we educated ourselves and people, we still were in the 19th century with that disease. In the 1990s, we had no idea how to solve that epidemic, and we finally did.

Today, we do know how to prevent, how to halt, and how to reverse the horrific trend of substance use disorder, which continues to be on the rise.

We need to make sure the front lines have the resources to address it. I believe a major piece of the equation is prevention. That is why I introduced this Alternatives to Opioids legislation, which enjoys strong bipartisan support.

The ALTO program was pioneered at St. Joseph's Medical Center in the city I have lived in all my life, Paterson, New Jersey. They started in the emergency room, Mr. Speaker, and now they are moving to other departments to use alternatives that are legitimate.

The president of that hospital, Kevin Slavin, and the head of Emergency Medicine, Dr. Mark Rosenberg, implemented innovative protocols to use

nonopioid treatments to address some of the most common painful conditions, like acute backache and headaches.

In its first 2 years, St. Joe's ALTO model has already led to an 82 percent reduction in opioid prescriptions. I think that is a big deal.

St. Joseph's has been replicating this model, as I said, beyond the emergency department to other departments. They are also teaching ALTO to other States and other hospitals that are now seeing similar success.

While ending the opioid epidemic will require a multifaceted approach, the initial success of this program and others like it are worthy of broader study and implementation. I recommend that, Mr. Speaker.

This bill establishes a demonstration program to test alternative pain management. Those protocols should be limited to the use of opioids in emergency departments. The Secretary of Health and Human Services will then report on the results of the program and make recommendations for broader implementation.

This bill will empower healthcare providers to prevent unnecessary opioids from getting into patients' hands and ultimately stop countless overdoses.

My motto for dealing with a zero tolerance, which I taught in the classroom, is the fact that we need to prevent these things from happening: No market, no sale. That is the center of everything I do in terms of drug prevention, because we are not going to pass enough legislation until the culture itself rids our inner sanctums of having to deal with our devils and have to deal with those things that get us off track every day, whether you are a student or an adult.

Mr. Speaker, I thank the gentlemen for their cooperation.

Mr. Speaker, I rise in strong support of H.R. 5197, the Alternatives to Opioids in the Emergency Department Act, or the ALTO Act.

Mr. Speaker, our nation faces an opioid crisis.

H.R. 5197, the ALTO Act, directs the Secretary of Health and Human Services to conduct a demonstration program to test alternative pain management protocols to limit the use of opioids in hospitals and emergency departments.

Opioids contributed to the deaths of more than 42,000 people in 2016, more than any year on official record.

Forty percent of all opioid overdose deaths involve a prescription opioid.

The economic burden of prescription opioid misuse in the United States is estimated to be $78.5 billion dollars per year.

This figure includes costs stemming from health care, including addiction treatment, lost productivity, and criminal justice involvement.

Over 200 million opioid prescriptions are written in the United States each year, and 2 million Americans have the symptoms of substance use disorder.

Approximately 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.

In Texas, 4 percent of the population reports using pain relievers for non-medical purposes.

Harris County, which contains my home district, has a pain medication misuse rate of 3.91 percent.

The time for action is now.

H.R. 5197, the ALTO Act, directs Health and Human Services to carry out a 3-year demonstration program which awards grants to hospitals and emergency departments to develop, implement, enhance, or study alternative pain management protocols and treatments that promote the appropriate limited use of opioids.

Emergency departments in several States, including in New Jersey and Colorado, have developed innovative programs to more widely utilize non-opioid pain treatments to reduce the use of opioids.

We must learn from these attempts and initiate a national program to limit the overuse of opioids in emergency settings.

However, it is important to realize that some groups, such as African Americans, are under-prescribed pain management medications.

We must balance these new programs that work to reduce over- prescription with our continued efforts to ensure that medically necessary treatment be provided to people in need.

H.R. 5197, the ALTO Act, is especially important for my district and the greater Houston area.

Houston is home to many world-renowned trauma centers including Ben Taub and Memorial Hermann.

These centers have extensive emergency medical services and they, along with hospitals around the state and the nation, will benefit greatly from the support this bill provides.

Mr. Speaker, it is time for Congress to intervene before opioids claim the lives of more Americans.

The Alternatives to Opioids in the Emergency Department Act, or the ALTO Act is a necessary step towards stopping this opioid crisis.

I urge my colleagues to join me in supporting H.R. 5197, the ALTO Act, to prevent opioid addiction at the source and ensure that this crisis is stopped.

Mr. Speaker, I rise in strong support of H.R. 5197, the Alternatives to Opioids in the Emergency Department Act, or the ALTO Act.

Mr. Speaker, our nation faces an opioid crisis.

H.R. 5197, the ALTO Act, directs the Secretary of Health and Human Services to conduct a demonstration program to test alternative pain management protocols to limit the use of opioids in hospitals and emergency departments.

Opioids contributed to the deaths of more than 42,000 people in 2016, more than any year on official record.

Forty percent of all opioid overdose deaths involve a prescription opioid.

The economic burden of prescription opioid misuse in the United States is estimated to be $78.5 billion dollars per year.

This figure includes costs stemming from health care, including addiction treatment, lost productivity, and criminal justice involvement.

Over 200 million opioid prescriptions are written in the United States each year, and 2 million Americans have the symptoms of substance use disorder.

Approximately 21 to 29 percent of patients prescribed opioids for chronic pain misuse them.

In Texas, 4 percent of the population reports using pain relievers for non-medical purposes.

Harris County, which contains my home district, has a pain medication misuse rate of 3.91 percent.

The time for action is now.

H.R. 5197, the ALTO Act, directs Health and Human Services to carry out a 3-year demonstration program which awards grants to hospitals and emergency departments to develop, implement, enhance, or study alternative pain management protocols and treatments that promote the appropriate limited use of opioids.

Emergency departments in several States, including in New Jersey and Colorado, have developed innovative programs to more widely utilize non-opioid pain treatments to reduce the use of opioids.

We must learn from these attempts and initiate a national program to limit the overuse of opioids in emergency settings.

However, it is important to realize that some groups, such as African Americans, are under-prescribed pain management medications.

We must balance these new programs that work to reduce over- prescription with our continued efforts to ensure that medically necessary treatment be provided to people in need.

H.R. 5197, the ALTO Act, is especially important for my district and the greater Houston area.

Houston is home to many world-renowned trauma centers including Ben Taub and Memorial Hermann.

These centers have extensive emergency medical services and they, along with hospitals around the state and the nation, will benefit greatly from the support this bill provides.

Mr. Speaker, it is time for Congress to intervene before opioids claim the lives of more Americans.

The Alternatives to Opioids in the Emergency Department Act, or the ALTO Act is a necessary step towards stopping this opioid crisis.

I urge my colleagues to join me in supporting H.R. 5197, the ALTO Act, to prevent opioid addiction at the source and ensure that this crisis is stopped.

Mr. Speaker, I yield myself such time as I may consume.

Mr. Speaker, I rise in support of H.R. 5197, the Alternatives to Opioids in the Emergency Department Act, introduced by my colleague from New Jersey, Representative Pascrell.

This legislation would create a demonstration program to support emergency departments in developing, implementing, enhancing, or studying alternative pain management protocols and treatments that limit the use of prescription opioids in emergency departments.

Supporting the development of additional protocols for alternatives to opioid medications as proposed by this bill can help reduce the number of those put at risk of addiction and lead to fewer fatal and nonfatal overdoses.

Mr. Speaker, I encourage my colleagues to support this legislation.

Mr. Speaker, I yield such time as he may consume to the gentleman from New Jersey (Mr. Pascrell), the sponsor of this bill.

Mr. Speaker, I urge support, urge my colleagues to support this bill, and I yield back the balance of my time.